Immigration Exams
A little preparation can prevent delays in the green card process. This guide explains what the exam is, what happens, and what to bring so you can arrive ready.
If you are preparing to file Form I-485 for a green card, you will need an immigration medical exam completed by a USCIS-designated civil surgeon. The result is Form I-693, which records your vaccination history and screens for a short list of health conditions that matter for immigration purposes.
This is not a routine annual physical. It is a structured exam defined by CDC technical instructions and performed by a civil surgeon, not just any primary care doctor.
The exam usually includes a review of your medical history, a physical examination, vaccination assessment, and screening for communicable diseases of public health significance. Tuberculosis testing is part of that process for most applicants, and additional testing may be needed if something in your history or exam requires follow-up.
The civil surgeon records the results on Form I-693, Report of Immigration Medical Examination and Vaccination Record. As current USCIS guidance requires many Form I-485 applicants to submit Form I-693 with the adjustment filing, it helps to schedule this exam early in your process.
Bring a government-issued photo ID such as a passport or driver's license, your original vaccination records if you have them, any prior TB or chest X-ray results, records of chronic conditions or previous surgeries, and your immigration paperwork if the clinic asks for it.
If your vaccination history is incomplete, do not worry. Your civil surgeon can use blood tests, also called titers, to check immunity for some diseases before recommending additional vaccines.
You can expect a focused history, a physical exam, a review of your immunization record, and testing for tuberculosis when required. The civil surgeon checks whether each vaccine is complete, not age appropriate, medically contraindicated, or still needed based on CDC guidance and your age.
Most adults and children do not need every vaccine on the list. Requirements vary by age, prior immunity, and vaccine history, so the exact recommendations are individualized.
If the civil surgeon identifies a Class A or Class B condition, that does not automatically mean your application is denied. In many cases, you may need more documentation, additional testing, treatment, or a waiver discussion depending on the issue.
If the exam raises a concern, it is best to review the next steps with both the civil surgeon and, when appropriate, an immigration attorney so you know exactly what USCIS will expect.
Keep the sealed Form I-693 envelope intact and store your copy safely until your case is decided. Before you leave, confirm the signature date and ask whether anything else is still pending so you do not have to return for avoidable paperwork issues.
The simplest way to avoid delays is to bring every record you can find, confirm that your civil surgeon is currently USCIS designated, and verify current filing instructions before you submit Form I-485.
Next Step
Lenox Medical Clinic performs immigration medical exams at our Doraville office with a multilingual team that can help confirm current requirements, pricing, and what to bring before you arrive.